This application proposes to establish The University of North Carolina at Chapel Hill as a new site for the Women's Interagency HIV Study (WIHS). The proposal represents a collaborative effort between investigators from The UNC Center for Infectious Diseases, Center for AIDS Research, Lineberger Comprehensive Cancer Center, and Cecil G. Sheps Center for Health Services Research. We propose to rapidly establish the UNC-WIHS cohort, contribute meaningfully to the national WIHS scientific program, and undertake an ambitious HIV research agenda that encompasses social epidemiology and health outcomes, advanced epidemiologic and biostatistical methods, pathogenesis, and molecular biology of cancer. We aim to: 1) Recruit and retain in follow-up a cohort of 200 HIV+ and 100 HIV- women who are at high risk for HIV infection and represent NC's HIV epidemic, thus expanding the WIHS Cohort to women who live in a region at the forefront of the US epidemic; 2) Characterize the relationship between socioeconomic context, changes in access to health insurance, and health outcomes among HIV+ and HIV- women; 3) Develop and apply novel epidemiologic and statistical methods using data from the UNC-WIHS and the entire WIHS cohort; 4) Characterize HIV persistence in the blood and genital tract among pre- and post-menopausal women; and 5) Investigate the pathobiology of breast and cervical cancers to identify immunological, microbial and genetic factors that affect cancer progression and treatment in HIV positive women. By contributing a diverse and complementary population of women, innovative science, and a strong, multidisciplinary cadre of investigators, UNC will enhance the efforts of the WIHS, expand the range of questions that can be addressed and, in collaboration with the entire group, improve the health of HIV+ women and women at high risk for HIV infection.